Journal of Diabetes Nursing
Year:2016 | Volume:4 | Issue:3|Papers Count:9

Introduction: Alexithymia and stress, as a critical risk factor, can intensify the symptoms of diabetes patients. Therefore, in this study we aimed to investigate the effectiveness of dialectical behavioral therapy in alexithymia, perceived stress, and diabetes symptoms among patients with type 2 diabetes.Methodology: This quasi-experimental study with a pretest-posttest design was performed on 30 subjects referred to Endocrinology clinic of Imam Khomeini Hospital, Tehran, Iran. The patients were randomly assigned to control and experimental groups. Dialectical behavioral therapy was conducted for the experimental group during eight sessions (90 minutes, once a week) followed by post-test. The data collection tools were Toronto Assessment Scale (Bagby, 1986) and Markham Mental Pressure Inventory (Markham, 1992). Statistical analysis was performed using analysis of variance (ANOVA) test.Results: In pre-test scores, ANOVA test showed a significant difference between the two groups in terms of alexithymia (F=16.05, P=0.01), perceived stress (F=30.09, P=0.01), and diabetes symptoms (F=4.47, P=0.04).Conclusion: The results indicated that dialectical behavioral therapy can be considered as an effective therapeutic intervention for diminishing alexithymia, perceived stress, and diabetes symptoms among diabetic patients.

Introduction: Gestational diabetes is one of the most common diseases during pregnancy, which could be initiated or diagnosed during this period for the first time. Given the importance of early diagnosis and timely management of this disease, this study aimed to evaluate the effect of spiritual training on decreased anxiety and increased quality of life of women with gestational diabetes in the assessment of nursing and modern care.Methodology: This quasi-experiment (with a pre- and post-test design)was conducted on all the women with gestational diabetes, who referred to the healthcare center of Pakdasht, Iran in 2015. In total, 30 patients were selected using available sampling and randomly divided into two groups of control and test(each group=15).In this research, eight 80-minute sessions of spiritual training were carried out for the test group, and the samples completed the Anxiety Scale Questionnaire by Cat tell and World Health Organization’s life quality questionnaire as a pre-and post-test. Data analysis was performed in SPSS version 19 using MANCOVA.Results: After the intervention, a significant difference was observed between the test and control groups regarding anxiety and quality of life. In other words, spiritual training led to a significant reduction in the anxiety level of patients, while increasing their quality of life (P≤0.01).Conclusion: According to the results of this study, a spiritual intervention could significantly contribute to the reduced level of anxiety and increases quality of life of patients. Therefore, it is suggested that the spiritual training method be used by therapists, counselors and clinical psychologists to alleviate anxiety and enhance quality of life of patients with gestational diabetes.

Introduction: Diabetes is mainly associated with negative psychological impacts on mental health of patients. Resilience training can potentially decrease such problems in patients. Therefore, this study aimed to evaluate the effectiveness of resilience training on psychological well-being of patients with type II diabetes.Methodology: This quasi-experiment(with a pretest-posttest design) was conducted on30 samples, selected from the Iranian Diabetes Association, Tehran, Iran, and randomly assigned to the control and test groups. Resilience training was performed for the test group in the form of nine sessions, followed by a post-test. Data collection tool included Ryff Scales of Psychological Well-being (RSPWB), and data analysis was performed using ANOVA.Results: In this study, the ANOVA test revealed a significant difference in the pre-test scores of the study groups regarding psychological well-being and its subscales, such as self-government, self-acceptance, goal orientation, control over external factors, self-development and positive relationship with others (P<0.0001).Conclusion: According to the results of this study, resilience training had a significant impact on improved psychological well-being of patients with type II diabetes. It is recommended that resilience training be used to enhance the quality of life of patients, as well as their ability to overcome problems in life.

Introduction: Diabetes is regarded as a metabolic disease and one of its characteristics is hyperglycemia, which could lead to fatal complications. One of the criteria for diagnosis and control of diabetes is measuring fasting plasma glucose and glycosylated hemoglobin. In addition, vitamin C can improve glucose tolerance. Therefore, this study was conducted to evaluate the effect of vitamin C on fasting plasma glucose and glycosylated hemoglobin (HbA1c) in patients with type II diabetes.Methodology: This controlled clinical trial was conducted on 74 eligible samples, randomly divided into two groups of test and control. Firstly, fasting plasma glucose and HbA1c were measured, followed by the treatment of the test group with vitamin C pills for three months. Data analysis was performed in SPSS version 19 using independent and paired t-tests.Results: Evaluation of the final results revealed a significant decrease in biochemical markers in the control group, compared to the test group. In other words, a significant difference was observed between the study groups after the intervention.Conclusion: According to the results of this study, vitamin C could reduce fasting plasma glucose and HbA1c in patients with type II diabetes through competition with glucose. This impact of vitamin C could be applied to control the pathogenic mechanism of protein glycation in diabetes after more accurate evaluations in this regard.

Introduction: Type II diabetes mellitus is associated with many complications. While oxidative stress has a significant role in the incidence of type II diabetes, antioxidative defense is remarkable in the prevention of this disease. The present study investigates the effect of eight weeks of endurance training and cinnamon supplement on antioxidant index and lipid peroxidation as an additional care in females with type II diabetes.Methodology: This study was conducted on 36 female volunteers with type II diabetes (age: 52.72±2.64 years and BMI: 29.28±2.94). Based on BMI, the participants were divided randomly into four groups including exercise, exercise-cinnamon, cinnamon, and control. Endurance training was performed for eight weeks (three sessions per week) at the intensity of 60-75% of maximum heart rate. The cinnamon supplement was administrated 1.5 g per day for the participants. Two days pre- and post-experiment, fasting blood samples were collected for the analysis of plasma levels of malondialdehyde and superoxide dismutase. Data were analyzed by paired t-test and factorial ANOVA, using SPSS software at the significant level of P<0.05.Results: According to the results, the levels of malondialdehyde decreased in the cinnamon and exercise groups. However, the exercise-cinnamon and control groups showed increased levels of malondialdehyde, which were significant only in the control group. Furthermore, the plasma concentration of superoxide dismutase decreased in all groups, which were significant in the cinnamon and exercise groups. There was no significant difference between the groups in the post-test.Conclusion: The findings of the current study showed that separate consumption of cinnamon or exercise can be effective in reducing lipid peroxidation. Nevertheless, simultaneous use of cinnamon supplements along with exercise needs further investigations.

Introduction: Diabetes is a chronic disease, the prevalence of which is three times higher among the elderly than the youth. Regular physical activity reduces the risk of mortality in people with diabetes. Therefore, the present study aimed to evaluate physical activity and balance control in the elderly with diabetes in Ilam, Iran.Methodology: This cross-sectional study was conducted on 180 elderly patients admitted in the internal medicine department, cardiac care unit, and post cardiac care unit of Ilam Hospital, using convenience sampling method. To collect the data, Physical Activity Questionnaire and balance sheet were employed. Data analysis was performed, using descriptive (mean and standard deviation) and inferential statistics (ANOVA, t-test) through SPSS version 21.Results: The results indicated that only 13.3% of the elderly had appropriate physical activity. A statistically significant relationship (P<0.05) was found between physical activity and the demographic characteristics (age, gender, education, income, marital status). However, the place of residence and employment status did not show any statistically significant relationship with physical activity (P>0.05). Likewise, there was no significant relationship between physical activity and balance control (P>0.05).Conclusion: Considering the importance of physical activity and balance control in patients with diabetes, the necessary interventions should be implemented to promote physical activity and balance control.

Introduction: Diabetes is a major healthcare concern, and physical activity is one of the most important modifiable and preventive factors in individuals with prediabetes. Transtheoretical model (TTM) is identified as a comprehensive approach for physical activity behavior change. Therefore, this study aimed to evaluate the physical activity of patients with prediabetes in based on TTM in Sabzevar, Iran.Methodology: This descriptive and analytical study was conducted on200 individuals with prediabetes, selected through randomized easy sampling. Evaluation was carried out throughthe completion of data collection tools (e.g., demographics questionnaire and constructs of TTM) by the samples. In addition, reliability and validity of the study tools were confirmed. Data analysis was performed in SPSS version 15.Results: In total, 70male and 130 female samples with mean age of 48.18±12.23 were evaluated. According to the results, 83% of the samples were in pre-action stages (precontemplation, contemplation, preparation), whereas only 17% of the subjects were in action and maintenance stages. Moreover, a significant difference was observed between the change stages and model’s constructs (P<0.000). It was demonstrated that self-efficacy, processes of change and decisional balance were increased with the progress of samples in the stages of change, from precontemplation to maintenance.Conclusion: According to the results of this study, most of the participants were in the precontemplation and contemplation stages. Therefore, it is recommended that propereducational programs be designed regarding the initiation of regular physical activity for specific groups, especially for those in precontemplation and contemplation stages of behavior change.

Introduction: Patient satisfaction is an important indicator of health care quality and it is important in health evaluation and planning. This study aimed to evaluate satisfaction of patients with type 2 diabetes with the care services provided in Endocrine and Metabolism Research Centre of Isfahan, Iran.Methodology: This descriptive study was performed on 230 type 2 diabetes patients, who were referred to Isfahan Endocrine and Metabolism Research Centre, Isfahan, Iran. The participants were chosen through convenience sampling method. Data was collected using a self-designed questionnaire consisting of four sections including satisfaction with the care provided by the physician, nurse, nutritionist, and laboratory. The questionnaire was rated using a five-point Likert scale. The data was analysed by using descriptive and inferential statistics and performing Chi-square, ANOVA, and logistic regression tests, using SPSS version 18.Results: The majority of the patients (87.9%) were satisfied with the care. The mean satisfaction scores from the care provided by physician, nurse, nutritionist, and laboratory were 25.8±2.54, 33.1±3.59, 26.3±4.3, and 24.3±2.57, respectively. A significant relationship was found between satisfaction and educational level (P=0.03) and age of the patients (P=0.004).Conclusion: The results of this study indicated that patients hold a positive attitude toward the services provided by diabetes team. However, satisfaction was low regarding diabetic foot care provided by the physician and follow-up of visits by nurses. Given that patients are the central part of a diabetes team, assessment of patient satisfaction with the performance of diabetes team could help health planners evaluate the performance of such centres.

Introduction: Diabetes is a major public health issue and one of the causes of disability and mortality worldwide. One of the main challenges to control this disease is lack of adherence to therapeutic regimen. Therefore, this study aimed to evaluate barriers to adherence to therapy in patients with diabetes.Methodology: This qualitative study was conducted on15 male and female patients with type II diabetes using semi-structured interviews. Data was collected during November 2015-June 2016. In addition, data analysis was performed using conventional qualitative content analysis.Results: Analysis of the findings of a series of extracted themes revealed three main the mesas barriers to adherence to therapy in patients with type II diabetes, as follows: "poor medical team performance" with subcategories of providing incomplete and contradictory information, non-cooperative performance of healthcare teams, failure to meet the needs of clients, loss of time, "social dilemma" with subcategories of occupation conditions, reaction of others, lack of harmony in the family and "personal distress" with subcategories of stress and depression, financial stress, effects of age, interference of personal desires with treatment goals.Conclusion: According to the results of this study, barriers to adherence to therapy in Iranian people with diabetes was related to the people's family and social background, which could turn to a challenge for the patient, leading to neglect of health behaviors. Identification of these factors by policy makers and healthcare providers is essential to facilitate the attitude of patients and their commitment to adherence to therapy and to prevent irreparable complications of diabetes.